MEDICARE: RYAN RAFFA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1043088560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN RAFFA

Provider Business Mailing Address
First Line	:	8301 BANPO BRIDGE WAY
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-0029
Country	:	US
Telephone Number	:	561-414-7926
Fax Number	:

Provider Business Practice Location Address
First Line	:	8301 BANPO BRIDGE WAY
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-0029
Country	:	US
Telephone Number	:	561-414-7926
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2023
Last Update Date	:	12/14/2023

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Directions to “ RYAN RAFFA ” Practice Location

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